Hand grip strength as a marker of functional impairment in chronic obstructive pulmonary disease patients

  • Neena RS Postgraduate resident, Department of Respiratory Medicine, Government Medical College, Trivandrum, Kerala, India
  • Fathahudeen A Professor and Head of the Department, Department of Respiratory Medicine, Government Medical College, Trivandrum, Kerala, India
  • Kamala R Assistant professor, Department of Respiratory Medicine, Government Medical College, Trivandrum, Kerala, India
Keywords: Hand Grip Strength; COPD; FEV1; BODE Index.

Abstract

Background: COPD is a heterogeneous lung disease with multisystem involvement. COPD patients not only suffer from respiratory function impairment but also from peripheral muscle dysfunction which is an important manifestation that hinders day-to-day activities. Patients with a reduction in muscle strength should be detected early so that an early intervention through pulmonary rehabilitation can be done. pMDIs which is a common inhalation device in COPD require adequate hand strength for its actuation making the upper limb muscle strength an important parameter which is often ignored in COPD patients.

Objectives: To determine the hand grip strength of COPD patients objectively. To determine the association between hand grip strength with FEV1,6-minute walk distance and BODE index.

Methods: This is a cross-sectional followed by a prospective observational study conducted in the Department of Respiratory Medicine, Government Medical College, Trivandrum, Kerala. In 72 COPD patients, hand grip strength was assessed using a Camry Digital Dynamometer and was compared with the age and gender-adjusted values. Spirometry was done in all 72 patients and FEV1 measurement was recorded. A 6-minute walk distance was determined; the BODE index was calculated in these patients which comprises BMI, FEV1, Dyspnea on the MMRC scale and distance walked in 6 minutes.

Results: COPD patients were found to have a reduction in their hand grip strength compared to their age and gender-adjusted values. In COPD patients, hand grip strength was found to have a positive correlation with a 6-minute walk distance whereas grip strength was found to have a negative correlation with BODE INDEX.

Conclusion: Hand grip strength is impaired in COPD patients and it could be used as a marker of functional impairment.

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References

REFERENCES
1) Global Initiative for Chronic Obstructive Lung Disease (GOLD). Global Strategy for the Diagnosis, Management and Prevention of COPD 2023

2) Halpin DMG, Celli BR, Criner GJ, et al. The GOLD Summit on chronic obstructive pulmonary disease in low- and middle-income countries. Int J Tuberc Lung Dis 2019; 23(11): 1131-41.

3) Meghji J, Mortimer K, Agusti A, et al. Improving lung health in low-income and middle-income countries: from challenges to solutions. Lancet 2021; 397(10277): 928-40.

4) Killian KJ, Leblanc P, Martin DH, Summers E, Jones NL, Campbell EJ. Exercise capacity and ventilatory, circulatory and symptom limitation in patients with chronic airflow limitation. Am Rev Respir Dis 1992

5) Hamilton AL, Killian KJ, Summers E, Jones NL. Muscle strength, symptom intensity and exercise capacity in patients with cardiorespiratory disorders. Am J Respir Crit Care Med 1995.

6) Maltais F, Decramer M, Casaburi R, et al. An official American Thoracic Society/European Respiratory Society statement: update on limb muscle dysfunction in chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2014; 189(9): e15-62.

7) Shah S, Nahar P, Vaidya S, Salvi S. Upper limb muscle strength & endurance in chronic obstructive pulmonary disease. Indian J Med Res. 2013 Oct;138(4):492-6.

8) Ntritsos G, Franek J, Belbasis L, et al. Gender-specific estimates of COPD prevalence: a systematic review and meta-analysis. Int J Chron Obstruct Pulmon Dis. 2018;13:1507-1514.

9) Grigsby M, Siddharthan T, Chowdhury MA, et al. Socioeconomic status and COPD among low- and middle-income countries. Int J Chron Obstruct Pulmon Dis. 2016;11:2497-2507.

10) Mannino DM, Buist AS. Global burden of COPD: risk factors, prevalence, and future trends. Lancet. 2007;370(9589):765–773

11) Dajczman E, Wardini R, Kasymjanova G, Préfontaine D, Baltzan MA, Wolkove N. Six minute walk distance is a predictor of survival in patients with chronic obstructive pulmonary disease undergoing pulmonary rehabilitation. Can Respir J. 2015;22(4):225-229.


12) Kamath S, Kumar A, Panda SK, Samanta RP. Correlation of BODE index with quality of life in stable Chronic Obstructive Pulmonary Disease (COPD) patients - A prospective study. J Family Med Prim Care. 2020;9(11):5606-5613.

13) Lupton-Smith A, Fourie K, Mazinyo A, Mokone M, Nxaba S, Morrow B. Measurement of hand grip strength: A cross-sectional study of two dynamometry devices. S Afr J Physiother. 2022;78(1):1768.


14) Kovarik M, Joskova V, Patkova A, Koblizek V, Zadak Z, Hronek M. Hand grip endurance test relates to clinical state and prognosis in COPD patients better than 6-minute walk test distance. Int J Chron Obstruct Pulmon Dis. 2017 Dec 1; 12:3429-3435
How to Cite
1.
R S N, A F, R K. Hand grip strength as a marker of functional impairment in chronic obstructive pulmonary disease patients . Int J Med Res Rev [Internet]. 2025Mar.3 [cited 2025Mar.14];13(1):33-1. Available from: https://ijmrr.medresearch.in/index.php/ijmrr/article/view/1519
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Original Article